Inflammation in atherosclerotic plaque is a key promoter of acute vascular syndromes (i.e., thrombosis). Panoply of cytokines, growth factors, and immune cellular infiltrates converges to dramatically enhance the local thrombogenic potential of unstable plaques by creating a hypercoagulant, tissue factor-rich milieu that is exposed by either plaque rupture or erosion, which results in vessel occlusion and hypoxic tissue death. The overarching theme of our continuing multidisciplinary translational effort is the development and clinical testing of nanoparticle based approaches for the diagnosis and therapy of thrombotic cardiovascular diseases to detect, treat, and monitor unstable atheroma. The initial phase of the program was devoted to novel molecular imaging strategies that have culminated in FDA approved clinical trials of integrin-targeted nanoparticles for plaque angiogenesis detection. In the next phase of the work, we seek to develop and quantify the efficacy of new nanotherapeutic agents to attenuate plaque inflammation with the clinical goal of reducing the propensity toward thrombosis in acute vascular syndromes. We will evaluate the following overarching hypothesis: anti- inflammatory therapeutic nanoparticles can modulate the hyperthrombotic state in acute vascular syndromes and restore stability in atherosclerotic lesions with benefits over and above conventional therapy. The specific aims are to: I. Design, formulate, and evaluate targeted anti-inflammatory nanotherapies in vitro II. Test therapeutic formulations in vivo in a standardized ApoE -/-mouse thrombosis model III. Test nanoparticle combinations and multiplexed nanoparticles in vivo for synergistic efficacy PUBLIC HEALTH RELEVANCE: Inflammation in atherosclerotic plaque is a key promoter of acute vascular syndromes (i.e., thrombosis). The theme of this proposal is the development and testing of nanoparticle based approaches for the diagnosis and therapy of cardiovascular diseases to detect, treat, and monitor unstable atheroma. We seek to develop new molecularly targeted nanotherapies that interrupt inflammatory signaling molecules with the clinical goal of reducing the propensity toward thrombosis in acute vascular syndromes. These will be tested in vivo in mouse models as single agent and combination therapies.